RESUMEN
Penetrating cervical lesions caused by a foreign body are rare events. The neck is a complex and delicate body region, given the important vascular structures it holds. The most frequent fatal complications often involve vascular injuries, and as a consequence, the mortality rate increases by approximately 50%. Civilian patients are mainly victims of violence or motor vehicle accidents and rural accidents involving neck are not very common. When a cervical lesion is because of a wooden foreign body, infectious risk increases for its organic peculiarity. The authors report a rural nonfatal cervical lesion in a civilian, and its management.
Asunto(s)
Cuerpos Extraños/complicaciones , Traumatismos del Cuello/etiología , Heridas Penetrantes/etiología , Endoscopía/métodos , Senos Etmoidales/lesiones , Estudios de Seguimiento , Cuerpos Extraños/cirugía , Hemostasis Quirúrgica/métodos , Humanos , Masculino , Persona de Mediana Edad , Cavidad Nasal/lesiones , Traumatismos del Cuello/diagnóstico , Traumatismos del Cuello/cirugía , Fracturas Orbitales/diagnóstico , Fracturas Orbitales/etiología , Fracturas Orbitales/cirugía , Madera , Heridas Penetrantes/diagnóstico , Heridas Penetrantes/cirugíaRESUMEN
Maxillofacial injuries are relatively frequent. These may be complicated by cranioencephalic injuries or large facial wounds. We report our experience with the initial management of these lesions in an emergency unit setting. In 2007, we observed 105 patients with maxillofacial injuries. Maxillofacial injuries were associated with cranio-encephalic injuries in 69 patients (65.7%) and with polytrauma in 31(29.5%), while in 5 cases (4.8%) they were isolated. The main causes of trauma were motorcycle accidents (60%). All patients were treated in accordance with the Advanced Trauma Life Support guidelines and assessed by computed tomography. No mortality was observed after diagnosis in the emergency unit or in the month following the trauma. Seventy-seven patients (73.3%) were admitted and 28 (26.7%) were treated and discharged. Accurate diagnosis and appropriate initial management yield good clinical outcomes with functional restoration and fewer aesthetic complications.
Asunto(s)
Traumatismos Maxilofaciales/cirugía , Traumatismo Múltiple/terapia , Accidentes de Trabajo , Accidentes de Tránsito , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Urgencias Médicas , Femenino , Humanos , Imagenología Tridimensional , Masculino , Traumatismos Maxilofaciales/diagnóstico , Traumatismos Maxilofaciales/diagnóstico por imagen , Traumatismos Maxilofaciales/etiología , Persona de Mediana Edad , Motocicletas , Traumatismo Múltiple/cirugía , Guías de Práctica Clínica como Asunto , Tomografía Computarizada por Rayos XRESUMEN
In the advanced nations trauma represents the third cause of death after cardiovascular diseases and tumours. Recently, great importance has been given to the need to treat traumas as quickly as possible in order to reduce mortality and morbidity. Prompt management of is the gold standard in the emergency setting and the phrase "golden hour" is now commonly used. The authors report on their experience with the management of multiple trauma, through the study of 617 clinical cases. Patients were evaluated with the Revised Trauma Score (RTS), Injury Severity Score (ISS) and Abbreviated Injury Scale (AIS). Of 420 (68%) cases of major trauma only one patient had ISS > 60. Patients were admitted on average after 47 +/- 18 min. Only two deaths occurred in the emergency unit. The task of the emergency unit is to stabilise the patients, anticipate the complications, including mainly shock and multiple organ failure, optimizing time, interventions and resources to reduce morbidity and mortality.
